Future Perspectives on Endoscopic Ultrasonography-Guided Therapy for Pancreatic Neoplasm

Abstract

Endoscopic ultrasonography (EUS)-guided therapy with ethanol injection or catheter-based radiofrequency ablation for pancreatic neoplasm has been conducted as a potential alternate treatment modality for patients who are not eligible for surgery. On the basis of the limited number of studies available, EUS-guided ablation therapy with the aforementioned methods for small pancreatic neoplasms has demonstrated promising technical feasibility and safety profiles. To be considered as a legitimate alternative option to surgery, however, EUS-guided ablation therapy must provide a long-term efficacy profile along with the consensus among experts regarding its treatment parameter. This review focuses on the clinical issues and future perspectives of EUS-guided therapy for pancreatic neoplasm.

Endoscopic ultrasound-guided ablation of pancreatic cystic neoplasms: ready for prime time?

“…Potential drawbacks to the use of EUS-guided cyst ablation include adverse events associated with endoscopic ablation, from either the endoscopy or the injection of ablative agents. Some adverse events noted in the literature include pancreatitis, abdominal pain, intra-cystic bleeding and thrombosis of the portal venous system, and rarely splenic vein thrombosis [6]. After ablation, some epithelium may remain untreated and therefore could continue to harbor malignant potential [7].…”